MRI对卵巢肿瘤的诊断价值

目的探讨卵巢肿瘤的MRI诊断价值。方法回顾性分析31例经手术病理证实的卵巢肿瘤患者的临床资料和MRI检查资料。结果卵巢囊腺瘤6例,其中1例浆液性囊腺瘤呈均匀单囊状,2例粘液性囊腺瘤呈多房状、分隔及囊壁薄,3例交界性粘液性囊腺瘤呈多房状、分隔及囊壁厚薄不均,可见壁结节;卵巢癌10例,多为囊实性肿块,增强后呈不均匀明显强化,术前误诊1例为卵巢转移瘤;卵泡膜纤维瘤组4例,1例单纯纤维瘤与2例卵泡膜纤维瘤的T2WI低信号有一定特征性,1例卵泡膜细胞瘤术前误诊为卵巢癌;卵巢畸胎瘤7例,均含有脂肪信号;卵巢转移瘤4例,3例胃癌转移所致,1例淋巴瘤累及所致。MRI对卵巢肿瘤的诊断符合率为93.5%。结论 MRI对卵巢肿瘤有较高的诊断价值,可作为临床理想的检查方法。     

卵巢囊腺瘤的CT诊断

目的:提高对卵巢囊腺瘤CT诊断及鉴别诊断能力。方法:回顾性分析手术病理证实的27例卵巢囊腺瘤的CT表现。结果:浆液性囊腺瘤5例,单房4例,多房1例,密度均匀,囊壁可薄可厚或厚薄不均。粘液性囊腺瘤9例,单房3例,密度均匀,囊壁厚,多房6例,密度不均匀,内见多发大小不等子囊。交界性(6例)和恶性变(7例)13例,其中浆液性3例,粘液性10例,12例为多房改变,囊壁及分隔增厚且边缘模糊,部分呈囊实性及壁结节改变,2例恶性变者伴有大量腹水。结论:单房浆液性囊腺瘤及多房粘液性囊腺瘤具有较典型CT表现,CT易于诊断及鉴别诊断,当病变呈囊实性改变,出现壁结节,或囊壁分隔不规则增厚模糊时,提示交界性或恶性变。     

腹部巨大囊性病变CT诊断

目的：探讨腹部巨大囊性病变的ＣＴ诊断和鉴别诊断要点。方法：腹部巨大囊性病变３０例,均经手术病理证实,分析其病变中心点、边界、囊壁、分隔、钙化、液平征、强化等要素。结果：中下腹包块１４便,有１５个包块。其中：卵巢浆液性囊腺瘤４例,５个包块。粘液性囊腺瘤３例,卵巢囊肿１例,卵巢－输卵管炎性囊肿１例,巨大膀胱憩室１例,成熟性囊性畸胎瘤４例;中上腹包块１３例,其中：囊性淋巴管瘤５例,和重复畸形囊肿２例,小     

卵巢囊腺癌的CT诊断

目的：评价卵巢囊腺癌的CT诊断价值。资料与方法：对41例经手术病理证实的卵巢囊腺癌（瘤）进行CT回顾性分析。结果：卵巢囊腺癌（瘤）的CT表现与文献报道基本一致。浆液性囊腺瘤表现为典型的I型，囊液密度均匀，浆液性囊腺癌呈Ⅱ型，其中Ⅱa型良恶性有部分重叠；当发现粘液性囊腺癌存在时，应考虑交界性甚至浆液性、粘液性囊腺癌存在的可能性。结论：卵巢囊腺癌（瘤）最常见部位为附件区。最常见的类型为Ⅰ、Ⅱ型。良性肿瘤以Ⅰ型常见，恶性肿瘤以Ⅱ型常见。CT可很好的显示卵巢肿瘤的内部特征，对缺乏浸润或转移证据的卵巢肿瘤的诊断和鉴别诊断有一定价值。     

粘液性与浆液性卵巢肿瘤的CT鉴别诊断

目的：探讨粘液性与浆液性卵巢肿瘤的CT鉴别诊断。方法：回顾性研究32例手术及病理确诊的粘液性及浆液性卵巢肿瘤的CT影像学特点，结合临床及病理特征，以此作为鉴别诊断的依据。结果：粘液性卵巢肿瘤12例，浆液性卵巢肿瘤22例。结论：粘液性与浆液性卵巢肿瘤的CT鉴别诊断须综合判断，包括分析房腔的多少、囊液的密度、囊壁的形态、分隔及软组织成分、远处转移等CT表现，还应结合临床资料。     

胰腺囊性病变的MRI诊断

目的　探讨MRI对胰腺囊性病变的诊断价值。方法　回顾性分析 19例经手术病理证实的胰腺囊性病变的MRI表现 ,并与手术病理对照 ,所有病例均行MRI平扫及增强扫描。结果　本组 19例胰腺囊性病变中先天性囊肿 2例 ,MRI表现为典型的长T1长T2 信号 ,囊壁薄而光整 ,囊内无分隔及实性组织成分。潴留性囊肿 3例 ,MRI表现为其与胰管相连 ,囊壁稍厚 ,信号均匀 ,囊肿近端均为胰腺癌。假性囊肿 6例 (急慢性胰腺炎所致 3例、外伤所致 2例、手术所致 1例 ) ,MRI表现为囊壁不规则 ,外伤性假囊肿信号复杂多变 ,胰腺炎性假囊肿MRI表现为长T1长T2 信号。感染性囊肿 3例 (结核 1例、脓肿 2例 ) ,MRI表现无特异性 ,肿瘤性囊肿5例 (浆液性囊腺瘤 2例、粘液性囊腺瘤或囊腺癌 1例、胰腺囊实性肿瘤 1例、胰腺癌囊性变 1例 ) ,肿瘤性囊肿多有软组织成分 ,囊壁多不规则 ,囊内多可见分隔。结论　MRI对胰腺囊性病变的诊断和鉴别诊断具有重要价值。     

肝内胆管囊腺瘤CT、MRI诊断

目的:总结肝内胆管囊腺瘤CT、MRI表现特点,评价CT、MRI对其诊断价值.方法:回顾性分析经手术病理证实的5例肝内胆管囊腺瘤临床及CT、MRI资料.结果:男2例,女3例;肝左叶4例,右叶1例;5例均为单发,单房2例.多房3例,囊壁结节或乳头状突起3例,囊壁点状钙化1例,胆总管囊状扩张2例,增强扫描囊壁、分隔、壁结节及乳头状突起强化.结论:肝内胆管囊腺瘤CT、MRI表现具有特征性,囊性病变伴有分隔、囊壁结节或乳头状突起提示囊腺瘤诊断,胆总管明显扩张是诊断与胆管相通粘液性囊腺瘤的一个重要间接征象.     

原发性卵巢恶性肿瘤的CT诊断

目的:探讨原发性卵巢恶性肿瘤的CT表现。方法:回顾经CT检查并手术病理证实的原发性卵巢恶性肿瘤20例的资料,分析其CT特征表现。结果:浆液性囊腺癌11例,交界性浆液性囊腺瘤1例,粘液性囊腺癌2例,交界性粘液性囊腺瘤2例,颗粒细胞瘤2例,恶性畸胎瘤2例。结论:CT可显示肿瘤的内部特征,对原发性卵巢恶性肿瘤的病理类型有一定的诊断价值。     

胰腺浆液性囊腺瘤的MRI特征

目的探讨胰腺浆液性囊腺瘤的MRI表现特征。方法回顾性分析10例胰腺浆液性囊腺瘤的MRI表现,包括肿瘤位置、瘤体直径、最大囊直径、分隔和中央瘢痕情况及胰胆管情况等影像学征象。结果 7例微囊型浆液性囊腺瘤:5例位于胰头部,2例位于胰体尾部。瘤体直径2.9～8.1cm,平均为5.1cm;最大囊直径0.9～6.8cm,其中5例小于2cm,平均为2.5cm,7例均可见分隔,6例可见中央瘢痕。增强扫描分隔均见强化,部分瘢痕强化,囊性成分均无强化。1例胰管轻度扩张,胆管无受累。3例少囊型浆液性囊腺瘤:2例位于胰头部,1例位于胰尾部。瘤体直径2.2～3.5cm,平均为2.8;最大囊直径2.2～3.0cm,平均为2.7cm,2例单囊,1例非单囊,无中央瘢痕。增强扫描分隔有强化,囊性成分无强化。3例胰管均无扩张,胆管无受累。结论典型的胰腺浆液性囊腺瘤MRI表现可以大致做出诊断,对于疾病的治疗,有一定的参考价值,但是最终诊断及分型还有赖于病理检查。     

MRI对卵巢良恶性病变的鉴别诊断价值

目的:探讨MRI对卵巢良恶性疾病的鉴别诊断价值。方法:分析66例经手术病理证实的卵巢疾病的MRI特征,良性病变36例,其中卵巢囊肿7例,巧克力囊肿5例,畸胎瘤10例,炎症肿块4例,浆液性囊腺瘤6例,粘液性囊腺瘤4例;恶性病变30例,其中浆液性囊腺癌10例,粘液性囊腺癌11例,内胚窦瘤4例,Krukenberg’s肿瘤5例。所有患者行常规扫描,平扫发现病灶行增强扫描,术后对所有病变行MR征象与病理结果对照分析。结果:MRI检查能很好显示卵巢病变的特征,其定位诊断100%,诊断的敏感性93%,特异性94%,准确性94%,卵巢癌分期准确性达85.0%。结论:MRI对卵巢良恶性病变的鉴别诊断价值大,并可提供卵巢癌分期所需的信息,增强扫描可进一步提高MR对卵巢癌的诊断及分期的准确性。     

低场MRI对女性盆腔良性肿瘤的诊断价值

目的：探讨低场MRI对女性盆腔良性肿瘤的诊断价值。方法：22例经手术病理证实的女性盆腔良性肿瘤患者，均行低场MRI检查，并将MRI诊断结果与病理结果相比较，明确低场MRI在女性盆腔良性肿瘤的诊断价值。结果：22例女性盆腔良性肿瘤，巨大子宫肌瘤8例，卯泡膜细胞瘤4例，浆液性囊腺瘤6例，卵巢囊肿1例，卵巢畸胎瘤3例。MRI诊断结果与病理符合17例，符合率90．91％。结论：低场MRI对女性盆腔良陛肿瘤诊断准确率较高，是女性盆腔良性肿瘤术前检查经济实用的影像学检查方法。     

Collision tumors of the ovary associated with teratoma: clues to the correct preoperative diagnosis

PURPOSE: Collision tumors represent a coexistence of two adjacent but histologically distinct tumors without histologic admixture in an organ. The purpose of this study was to describe the imaging findings of collision tumors of the ovary associated with teratoma and to look for clues that might lead to the correct preoperative diagnosis. METHOD: Seven pathologically proven cases of collision tumor of the ovary associated with teratoma were retrospectively reviewed. Ovarian teratomas were coexistent with mucinous cystadenoma (n = 4), borderline mucinous tumor (n = 1), mucinous cystadenocarcinoma (n = 1), and dysgerminoma (n = 1). US (n = 5), CT (n = 3), and/or MRI (n = 4) findings were evaluated. RESULTS: In addition to the typical findings of teratoma, the mass contained a multiloculated cystic portion filled with nonfatty fluid, suggesting the coexistent epithelial tumor in five cases. In one case, the mass contained a large solid component, suggesting the possibility of collision tumor. In the remaining one case, coexistent small mucinous cystadenoma could not be identified. CONCLUSION: Preoperative imaging for ovarian teratoma revealed a collision tumor in six of seven cases. The possibility of a collision tumor should be considered when an ovarian teratoma has imaging findings that cannot be explained solely by an ovarian teratoma.     

卵巢囊腺瘤的CT诊断(附22例报告)

目的 确定CT对卵巢囊腺瘤的诊断价值。方法 对超声诊断不满意的21例卵巢囊腺瘤的CT表现进行回顾性分析，并与手术病理所见进行了对照。结果 22例卵巢囊腺瘤患中，浆液性囊腺瘤见于15例，粘液性囊腺瘤5例，交界性粘液性囊腺瘤2例。与术后病理结果对照，CT正确诊断了22例中的21例(95％)。CT探测单侧单发性卵巢囊腺瘤病变的准确率为100％(n=22／22)。结论 CT在卵巢囊腺瘤的诊断中，能清晰显示其内部特征及其病变与周围组织的关系，因而，它是一神可靠、有效的诊断方法。但是，CT对交界性卵巢囊腺瘤和卵巢囊腺瘤的恶变难以做出准确的定性诊断，多数情况下需经手术病理证实。     

低场磁共振成像对卵巢巧克力囊肿与囊性畸胎瘤鉴别诊断价值的研究

目的 探讨低场磁共振成像(MRI)在卵巢巧克力囊肿与囊性畸胎瘤临床鉴别诊断中的价值.方法 回顾性分析经手术及病理证实的卵巢巧克力囊肿22例,囊性畸胎瘤13例,分析各自的MRI表现特点.结果 22例巧克力囊肿术前诊断正确19例,其中3例术前诊断为囊性畸胎瘤,MRI诊断符合率86％(19/22);13例囊性畸胎瘤术前诊断正确12例,1例术前判断为巧克力囊肿,符合率92％(12/13).所有巧克力囊肿和畸胎瘤病例在SET1WI序列下均可见到病灶内高信号区.当使用短时间反转恢复序列(STIR)脂肪抑制序列时,所有高信号区可见不同程度信号减低;当使用GRE同、反相位T1加权成像时,畸胎瘤内的T1WI高信号病灶在反相位图像上会出现明显信号减低区,而巧克力囊肿不会出现信号减低区.结论 卵巢巧克力囊肿与囊性畸胎瘤MRI诊断准确性较高.使用GRE同、反相位T1加权成像对两者的鉴别诊断有特殊价值.     

卵巢囊腺瘤与囊腺癌的CT诊断

目的探讨CT在卵巢囊腺瘤和囊腺癌中的诊断价值。资料与方法回顾性复习经手术和病理证实的13例卵巢囊性肿瘤，总结其CT表现和特征。结果13例中浆液性囊腺瘤7例，黏液性囊腺瘤4例；浆液性乳头状囊腺癌Ⅰ例（Ⅱa型），黏液性囊腺癌Ⅰ例（Ⅱb型）。囊腺瘤表现为薄壁的单房或多房囊肿，无壁结节；囊腺癌表现为不规则厚壁，间隔增厚，并有壁结节，软组织成分多。术前CT诊断正确Ⅱ例（84．6％），误诊2例（15、4％）。结论CT能很好显示卵巢囊腺瘤、囊腺癌的特征，在鉴别良、恶性卵巢囊腺性肿瘤上有价值。     

Serous cystadenoma of the pancreas: imaging findings]

PURPOSE: To present the imaging findings of serous cystadenoma (SCA) and discuss the main problems of differential diagnosis with other cystic pancreatic lesions. MATERIALS AND METHODS: 55 cases of SCA were reviewed; all the lesions proved to be benign at pathology. 35 tumors were evaluated with Ultrasonography (US), 49 with Computed Tomography (CT), and 15 with Magnetic Resonance Imaging (MRI). RESULTS: Among the patients who underwent either demolitive (47) or derivative (3) interventions, two different morpho-structural patterns were identified: microcystic (37), and oligocystic (13). The diagnosis of SCA, possible in the presence of microcystic pattern, was achieved in 63% of cases by US (22/35), in 63% of cases by CT (31/49), and in 73% of cases by MRI (11/15). In 12 patients evaluated with all the imaging modalities, the combined information allowed a correct diagnosis in 10 cases (83%). The 13 oligocystic tumors were almost always undistinguishable from other cystic masses of the pancreas. CONCLUSIONS: The diagnosis of SCA can be considered certain if a microcystic pattern is detected. A correct diagnosis is not achievable in the presence of oligocystic architecture. MRI is the best imaging modality in characterizing this tumor.     

Brenner tumor of the ovary: CT and MR findings

PURPOSE: The purpose of this study was to determine the CT and MR characteristics of Brenner tumors, rare epithelial neoplasms of the ovary. METHOD: CT and MR scans of eight pathologically proven Brenner tumors of the ovary (seven benign, one malignant, and one associated with mucinous cystadenoma) were retrospectively reviewed. The masses were analyzed for location, size, external configuration, internal architecture, enhancement pattern, presence of calcification, and metastatic spread. RESULTS: The patients' median age was 63 years (range 39-79 years), and the mean size of the tumors was 11.4 cm (7.5-17 cm). All tumors were unilateral and had a well-defined margin. The mass was mostly solid in three, mostly cystic in one, and "mixed" solid and cystic in four cases. The tumors with cystic components (n = 5) were mostly multilocular in appearance (n = 4). All the solid components showed mild homogeneous enhancement on postcontrast CT and MRI. Extensive amorphous calcification within the solid component on CT was seen in five of six cases (83%). No characteristic findings discriminating malignancy from benign Brenner tumor could be found. CONCLUSION: Extensive amorphous calcification in a solid mass or solid component in a multilocular cystic mass is a characteristic finding of Brenner tumor of the ovary on CT and MRI.     

腹膜假性黏液瘤CT诊断(附21例报告)

目的:探讨腹膜假性黏液瘤的CT表现,提高对本病的认识.方法:搜集经手术、病理证实的腹膜假性黏液瘤21例,回顾性分析其CT表现.结果:21例中原发瘤恶性8例,其中卵巢黏液囊腺癌3例,阑尾黏液囊腺癌4例,结肠黏液腺癌1例;良性13例,其中阑尾黏液囊腺瘤4例,阑尾黏液囊肿2例,卵巢黏液囊腺瘤6例,胰腺黏液囊腺瘤1例.CT平扫见肝脾等实质脏器边缘扇贝样或结节状压迹,腹腔不规则囊实性肿块,CT值19.9～25.8 HU;脏器周围、网膜间隙、腹腔、盆腔见大量黏液性腹水,CT值10～15 HU;腹膜增厚,厚度1.0～2.0 cm;增强扫描显示囊实性病变仅见囊壁、网膜、腹膜轻度强化,囊内病灶无明显强化.结论:腹膜假性黏液瘤CT表现具有一定的特征,是诊断腹膜假性黏液瘤的重要方法.     

前联合单纯性血管周围间隙扩大的影像学诊断

目的:探讨前联合单纯性血管周围间隙扩大的影像学表现。方法:回顾性分析22例前联合单纯性血管周围间隙扩大的CT、MRI表现和临床资料。CT检查9例,MRI检查11例,同时行两项检查2例。结果:本组22例,单侧发病10例,双侧发病12例,病灶均呈脑脊液密度或信号影,呈圆形、卵圆形或三角形,最大径约0.2~1.2cm不等。病灶长轴沿前联合纤维走行方向分布。结论:前联合单纯性血管周围间隙扩大的程度与病人的年龄没有直接的关系,多层螺旋CT及MRI均能很好地显示病灶,对本病的诊断MRI优越于CT。